Clinical significance of pharmacokinetic interactions between antiepileptic and psychotropic drugs

Epilepsia
E Spina, E Perucca

Abstract

As antiepileptic drugs (AEDs) and psychotropic agents are increasingly used in combination, the possibility of pharmacokinetic interactions between these compounds is relatively common. Most pharmacokinetic interactions between AEDs and psychoactive drugs occur at a metabolic level, and usually involve changes in the activity of the cytochrome P450 mixed-function oxidases (CYP) involved in their biotransformation. As a consequence of CYP inhibition or induction, plasma concentrations of a given drug may reach toxic or subtherapeutic levels, and dosage adjustments may be required to avoid adverse effects or clinical failure. Enzyme-inducing AEDs, such as carbamazepine (CBZ), phenytoin (PHT), and barbiturates, stimulate the oxidative biotransformation of many concurrently prescribed psychotropics. In particular, these AEDs may decrease the plasma concentrations of tricyclic antidepressants, many antipsychotics, including traditional compounds, i.e., haloperidol and chlorpromazine, and newer agents, i.e., clozapine, risperidone, olanzapine, quetiapine, and ziprasidone, and some benzodiazepines. Conversely, new AEDs appear to have a lower potential for interactions with all psychotropic drugs. While antipsychotics and anxiolytics d...Continue Reading

References

Nov 1, 1979·Clinical Pharmacology and Therapeutics·L TräskmanG Tybring
Sep 1, 1978·Clinical Pharmacology and Therapeutics·A A LaiR E Cutler
Jan 1, 1977·European Journal of Clinical Pharmacology·J P MoodyG J Naylor
Jun 1, 1977·British Journal of Clinical Pharmacology·D S HewickI D Watson
Aug 1, 1977·British Journal of Clinical Pharmacology·E Perucca, A Richens
Oct 1, 1975·British Journal of Clinical Pharmacology·R A BraithwaiteA Richens
Sep 1, 1992·Trends in Pharmacological Sciences·F J Gonzalez
Feb 1, 1992·Journal of Neurology, Neurosurgery, and Psychiatry·F PisaniR Di Perri
May 1, 1992·Journal of Neurology, Neurosurgery, and Psychiatry·P Jalil
Jan 1, 1991·European Journal of Clinical Pharmacology·E SpinaJ Benitez
Oct 1, 1991·Journal of Clinical Psychopharmacology·E LeinonenP Ylitalo
Dec 1, 1991·Acta Psychiatrica Scandinavica·J FritzeM Lanczik
Jul 1, 1991·Clinical Pharmacology and Therapeutics·S R GrimsleyM J D'Souza
Oct 1, 1988·Journal of Clinical Psychopharmacology·R J BaldessariniM H Stein
Jan 1, 1988·European Journal of Clinical Pharmacology·Y F ChengJ Gabrielsson
Mar 1, 1987·Drug Intelligence & Clinical Pharmacy·C D SandsC Muniz
Oct 1, 1986·Journal of Neurology, Neurosurgery, and Psychiatry·F PisaniR Di Perri
May 1, 1986·The American Journal of Psychiatry·G W AranaR I Shader
Apr 1, 1985·Journal of Clinical Psychopharmacology·M W JannC L Bowden
Oct 9, 1971·British Medical Journal·G D Burrows, B Davies
Mar 1, 1970·Archives of General Psychiatry·S H CurryJ H Marshall
Dec 1, 1983·Neurology·P E Gay, J A Madsen
Jul 1, 1980·The American Journal of Psychiatry·M LinnoilaJ Auvinen
Dec 1, 1981·British Journal of Clinical Pharmacology·S Dhillon, A Richens
Jul 1, 1980·Annals of Internal Medicine·F M Vincent
Feb 1, 1995·Psychopharmacology·E SpinaE Perucca
Apr 1, 1995·The American Journal of Psychiatry·L P Longo, C Salzman
Jan 1, 1995·Pharmacopsychiatry·J TiihonenP Hakola
Oct 1, 1994·Biological Psychiatry·P Finley, D Warner
Dec 1, 1994·Journal of Clinical Psychopharmacology·R I ShaderL L von Moltke
Jun 1, 1994·Seizure : the Journal of the British Epilepsy Association·J Darley
Aug 14, 1993·Lancet·S M DursunM A Reveley
Oct 1, 1993·Therapeutic Drug Monitoring·B E GidalA J Wilenksy

❮ Previous
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Citations

Feb 18, 2005·Der Nervenarzt·S Beyenburg, D Schmidt
Jan 3, 2007·Neurotherapeutics : the Journal of the American Society for Experimental NeuroTherapeutics·Steven C Schachter
Apr 15, 2005·Pharmacological Research : the Official Journal of the Italian Pharmacological Society·Ehab S El DesokyJean-Pascal Siest
Jul 16, 2003·Epilepsia·Günter Krämer
Aug 21, 2004·Journal of Child and Adolescent Psychopharmacology·Joseph Gonzalez-HeydrichJoseph Biederman
Jan 24, 2009·AIDS·Monica GandhiUNKNOWN Women's Interagency HIV Study (WIHS)
Jun 23, 2005·Epilepsia·Emilio Perucca
Sep 29, 2012·Epilepsia·Martin J BrodieDieter Schmidt
Apr 12, 2014·British Dental Journal·N RansfordN Huggins
Jun 19, 2013·Journal of Clinical Psychopharmacology·Stefan UntereckerBruno Pfuhlmann
Mar 23, 2013·Journal of Addiction Medicine·Danielle Baribeau, Keyghobad Farid Araki
Jun 11, 2004·Clinical Neuropharmacology·Luigi M SpecchioLuigi Murri
Mar 30, 2005·Clinical Neuropharmacology·Jessica Fleming, Manoranjenni Chetty
Mar 7, 2006·Clinical Neuropharmacology·Constantin TranulisDavid Gourion
Jan 19, 2006·Therapeutic Drug Monitoring·Takuya MasuiTsukasa Koyama
Jan 20, 2006·International Clinical Psychopharmacology·Wolfgang AichhornGeorg Kemmler
Jul 13, 2006·Expert Review of Neurotherapeutics·Cheryl A Frye
Dec 22, 2009·Expert Review of Neurotherapeutics·Cecilie Johannessen Landmark, Philip N Patsalos
Sep 10, 2014·Expert Opinion on Drug Metabolism & Toxicology·Domenico ItalianoJose de Leon
Feb 21, 2016·Pharmacological Research : the Official Journal of the Italian Pharmacological Society·Edoardo SpinaJose de Leon
Dec 15, 2012·Pharmacological Reports : PR·Kinga K BorowiczStanisław J Czuczwar
Apr 13, 2015·Epilepsy & Behavior : E&B·Jay A SalpekarAaron J Hauptman
Aug 12, 2009·Progress in Neuro-psychopharmacology & Biological Psychiatry·Chun-Yen ChenChih-Lun Chen
Oct 27, 2007·The Journal of Emergency Medicine·Revital Gandelman-MartonJose Martin Rabey
Jan 12, 2007·Basic & Clinical Pharmacology & Toxicology·Edoardo Spina, Jose de Leon
Feb 21, 2006·British Journal of Clinical Pharmacology·Emilio Perucca
Feb 9, 2012·Human Psychopharmacology·Maria Rosaria MuscatelloDavid S Baldwin
Feb 8, 2005·Progress in Neuro-psychopharmacology & Biological Psychiatry·Takuya MasuiTsukasa Koyama
Apr 5, 2016·Dental Clinics of North America·Janet H Southerland, Lawrence R Brown
Sep 8, 2005·Psychosomatics·Neil B SandsonKelly L Cozza
Aug 2, 2005·Epilepsy & Behavior : E&B·Stefan BeyenburgMarkus Reuber
Apr 28, 2005·Expert Review of Neurotherapeutics·Marco MulaMichael R Trimble
Dec 1, 2010·European Journal of Pharmacology·Kazuaki KawauraKazuo Takahama
Jun 9, 2016·Expert Opinion on Drug Metabolism & Toxicology·Monika BanachStanisław J Czuczwar
Jan 1, 2012·Pharmaceuticals·Leonard Amaral, Joseph Molnar
Apr 19, 2019·International Clinical Psychopharmacology·Michele FabrazzoFrancesco Catapano

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